When Medicare was created in 1965, prescription drugs were not an essential component of patient care. However, medical advancements in recent decades have enabled doctors to treat a wide range of diseases and ailments with prescription drugs. But the costs of prescription drugs have skyrocketed and many seniors have been unable to afford the drugs they need to stay healthy. Consequently, proposals to expand prescription drug coverage have been a fixture on the congressional agenda in recent years; Republicans have generally favored approaches that would subsidize private insurance companies to provide drug coverage, while Democrats have advocated for drug coverage through the Medicare program. Earlier in the congressional session, both the House and the Senate completed action on a proposal which would provide Medicare recipients with prescription drug coverage through private insurers (rather than through Medicare). Essentially, the plan would use HMOs and other private insurance companies as a third-party contractor to provide prescription drug coverage to seniors. Additionally, the House version of the legislation would, by 2010, allow private insurers to compete directly with the Medicare program to provide health benefits traditionally covered by Medicare (the Senate's version of the bill did not include this language). On this vote, Representative Davis (D-FL) motioned to instruct House conferees-those lawmakers selected by the House leadership to reconcile differences between the House and Senate versions of the bill in conference committee negotiations with the Senate-to drop language in the House bill which would allow private health plans to compete directly with Medicare by 2010. In the view of Progressives, allowing private plans to compete directly with Medicare would reduce the quality of health coverage for the nation's seniors. In contrast to private health insurance plans-plans which can drop an individual's coverage in certain situations where the cost of his or her healthcare becomes too expensive to the private insurer and limit a patient to only those doctors and hospitals that have been approved by the insurance company-the health coverage provided through Medicare applies equally to all seniors, is never reduced based on one's health needs, and allows seniors to choose their doctor and hospital. Conservatives opposed the motion to instruct for two main reasons. First, in the view of Conservatives, allowing private plans to compete directly with Medicare will provide seniors with more choices regarding their health coverage. Second, Conservatives argued that economic competition between private health insurers and Medicare would result in lower prices for consumers. On a party line vote of 195-217, the motion was defeated and House conferees were not instructed to drop the free-market provisions contained in the House bill when drafting the final version of the legislation in conference committee. (Note: Five other attempts were made by Democrats to prevent competition between Medicare and private insurance companies; see House votes 573, 615, 619, 637, and 650.)